Claim Edit Specialist - Remote

QP Claim Edit Specialist - Remote
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QualDerm Partners is a leading dermatology network dedicated to empowering dermatologists through strategic partnerships and comprehensive management support.
QualDerm Partners
Employee count: 1001-5000
United States only

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With 150+ locations in 17 states, QualDerm Partners is the largest multi-state female-founded and owned dermatology network in the U.S. At QualDerm Partners , we are united in our purpose: to educate, protect, and care for your skin. We are committed to bringing you the very best in comprehensive skin care so that you can achieve a confident, healthier, and more beautiful you!

Our mission is to educate communities and healthcare professionals about the importance of skin health; including skin cancer prevention, risk factors and how to achieve healthy skin through annual skin exams and dermatologic care. We strive to provide the latest proven, proactive and comprehensive dermatologic care to populations in the expanding geographies we serve by making high-quality skin care timelier and more accessible all while creating a rewarding work environment for our providers and employees.

Purpose: Responsible for identifying and resolving third-party payer rejections. Will assist in resolution of edits/ errors that may result in nonpayment of charges or prevent charges from being accepted by payers. Also responsible for entering bills/charges with input from certified coding team when necessary.
Essential Duties and Responsibilities:
- Manage claims returned which have failed scrub rules
- Identify and resolve payer rejections in a timely manner.
- Enter charges/bills into EMR in coordination with certified coding team/Coding manager
- Monitor missing charges and communicate with RCM management as needed
- Must have knowledge of claim correction, electronic claim submission
- Ability to contact payers when necessary to resolve any issues
- Report any trends in a timely manner to RCM leadership that prevent successful claim submission
- Ability to effectively communicate with other departments such as Coding, AR/Follow-up, Patient Services and Posting

Requirements
- 1-3 years’ experience in a medical/insurance environment for physician practice or billing company
- Revenue cycle experience preferred
- Complete Modernizing Medicine University courses within 6 months of hire
- Strict attention to detail
- Ability to meet deadlines in a fast paced, start-up, results-oriented environment, as well as excellent organizational skills
- Excellent verbal and written communication skills
- Proficient Microsoft Office Suite products, specifically Excel and ability to analyze large data sets
- Ability to collaborate and work in a team environment

Benefits
Benefits of joining Qualderm Partners:
- Competitive Pay – Attractive compensation to reward your hard work
- Comprehensive Health Coverage – Includes Medical, Dental, and Vision plans to keep you covered
- Generous 401(k) Plan – Company matches 100% of the first 3%, plus 50% of the next 2%, with immediate vesting
- Paid Time Off (PTO) – Accrue PTO from day one, plus enjoy 6 paid holidays and 2 floating holidays each year
- Company-Paid Life Insurance – Peace of mind with basic life coverage, with the option for additional plans
- Disability Protection – Short-term and long-term disability coverage to protect you in unexpected circumstances
- Additional Wellness Plans – Accident, critical illness, and identity theft protection plans for extra security
- Employee Assistance Program (EAP) – Access confidential support for personal or work-related challenges
- Exclusive Employee Discounts – Save on products and services with special discounts just for you
- Referral Bonus Program – Earn bonuses by referring qualified candidates to join the team

QualDerm Partners is proud to be an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. Applicants must be currently authorized to work in the United States in a full-time basis.

Compensation Range: $19.35 - $27.33 per hour. Final offer will be based on a combination of skills, experience, location, and internal equity.

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About the job
Apply before
Oct 22, 2026
Posted on
Aug 23, 2026
Job type
Full Time
Experience level
Mid-level

Experience

1 year minimum

Location requirements
Suggest an edit

United States

Hiring timezones
Show UTC offsets

United States +/- 0 hours

Job categories
Claims Processing Medical Billing Revenue Cycle Management Healthcare Administration Hospital And Health Care Remote Claims Specialist Remote Claims Analyst Remote Insurance Claims Specialist Remote Claims Processor Claims Edit Auditor

Skills
Medical Billing EMR Excel Health Insurance Payer Relations Insurance Claim Scrubbing Communication Skills Collaboration

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About QualDerm Partners

Learn more about QualDerm Partners and their company culture.

View company profile

QualDerm Partners: A Skin & Aesthetics Wellness Family Dedicated to Supporting High-Quality Patient Care. A Quality-First Network for Dermatologists & Skin Care Experts Across the Continental United States. QualDerm Partners empowers top-tier dermatologists to position their practices for long-term, sustainable growth and enhanced profitability. We achieve this by fostering market-leading practice partnerships through strategic affiliations and the development of new practices (de novo). With a deep understanding of the dermatology landscape, QualDerm provides comprehensive management support, access to capital, and expert guidance to drive growth and maximize operational efficiency.

Our collaborative approach enables dermatologists to focus on delivering exceptional patient care while we handle the complexities of practice management, ensuring both immediate success and a strong foundation for future expansion. QualDerm Partners supports 158 practices in 17 states, spanning across the full spectrum of dermatology, skin cancer care, cosmetics, plastic surgery, and pathology with continued plans to expand further across the nation. We see, on average, over 120,000 patients every month and support more than 350 providers.

Apply now
Job expired?

Please let QualDerm Partners know you found this job on Himalayas. This helps us grow!
Apply now

About the job
Apply before
Oct 22, 2026
Posted on
Aug 23, 2026
Job type
Full Time
Experience level
Mid-level

Experience

1 year minimum

Location requirements
Suggest an edit

United States

Hiring timezones
Show UTC offsets

United States +/- 0 hours

Job categories
Claims Processing Medical Billing Revenue Cycle Management Healthcare Administration Hospital And Health Care Remote Claims Specialist Remote Claims Analyst Remote Insurance Claims Specialist Remote Claims Processor Claims Edit Auditor

Skills
Medical Billing EMR Excel Health Insurance Payer Relations Insurance Claim Scrubbing Communication Skills Collaboration

Browse similar jobs
Remote Mid-level Claims-Processing Jobs Remote Full Time Claims-Processing Jobs Remote Mid-level Claims-Processing Jobs in United States Remote Full Time Jobs in United States Remote Claims-Processing Jobs in United States

Claim this profile QP QualDerm Partners

Company size

1001-5000 employees

Founded in

2014

Chief executive officer

William Southwick

Markets
Healthcare Dermatology Aesthetic Wellness Medical Practice Management Cosmetic Surgery Plastic Surgery Pathology Services Healthcare Consulting Healthcare Operations Skincare

Employees live in
United States

View company profile

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